Xiao Xian-Pei, Dai Yong-Jun, Zhang Yu, Yang Meng, Xie Jian, Chen Guo, Yang Zheng-Jun
Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China.
Department of Orthopaedics, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China.
World J Clin Cases. 2024 Mar 6;12(7):1215-1226. doi: 10.12998/wjcc.v12.i7.1215.
Although the etiology of nonalcoholic fatty liver disease (NAFLD) has not been thoroughly understood, the emerging roles of anthropometric indicators in assessing and predicting the risk of NAFLD have been highlighted by accumulating evidence.
To evaluate the causal relationships between five anthropometric indicators and NAFLD employing Mendelian randomization (MR) design.
The Anthropometric Consortium provided genetic exposure data for five anthropometric indicators, including hip circumference (HC), waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and body fat percentage (BF). Genetic outcome data for NAFLD were obtained from the United Kingdom Biobank and FinnGen Consortium. Genome-wide significant single nucleotide polymorphisms were chosen as instrumental variables. Univariable MR (UVMR) and multivariable MR (MVMR) designs with analytical approaches, including inverse variance weighted (IVW), MR-Egger, weighted median (WM), and weighted mode methods, were used to assess the causal relationships between anthropometric indicators and NAFLD.
Causal relationships were revealed by UVMR, indicating that a higher risk of NAFLD was associated with a per-unit increase in WC [IVW: odds ratio (OR) = 2.67, 95%CI: 1.42-5.02, = 2.25 × 10], and BF was causally associated with an increased risk of NAFLD (WM: OR = 2.23, 95%CI: 1.07-4.66, = 0.033). The presence of causal effects of WC on the decreased risk of NAFLD was supported by MVMR after adjusting for BMI and smoking. However, no causal association between BF and NAFLD was observed. In addition, other causal relationships of HC, WHR (BMI adjusted), and BMI with the risk of NAFLD were not retained after FDR correction.
This study establishes a causal relationship, indicating that an increase in WC is associated with a higher risk of NAFLD. This demonstrates that a suitable decrease in WC is advantageous for preventing NAFLD.
尽管非酒精性脂肪性肝病（NAFLD）的病因尚未完全明确，但越来越多的证据凸显了人体测量指标在评估和预测NAFLD风险方面的新作用。
采用孟德尔随机化（MR）设计评估五项人体测量指标与NAFLD之间的因果关系。
人体测量学联盟提供了五项人体测量指标的基因暴露数据，包括臀围（HC）、腰围（WC）、腰臀比（WHR）、体重指数（BMI）和体脂百分比（BF）。NAFLD的基因结局数据来自英国生物银行和芬兰基因联盟。选择全基因组显著的单核苷酸多态性作为工具变量。采用单变量MR（UVMR）和多变量MR（MVMR）设计以及包括逆方差加权（IVW）、MR-Egger、加权中位数（WM）和加权模式法在内的分析方法，评估人体测量指标与NAFLD之间的因果关系。
UVMR揭示了因果关系，表明WC每增加一个单位，NAFLD风险更高[IVW：比值比（OR）=2.67，95%置信区间：1.42 - 5.02，P = 2.（此处原文可能有误，推测为2.25×10⁻²）]，且BF与NAFLD风险增加存在因果关系（WM：OR = 2.23，95%置信区间：1.07 - 4.66，P = 0.033）。在调整BMI和吸烟因素后，MVMR支持WC对降低NAFLD风险存在因果效应。然而，未观察到BF与NAFLD之间的因果关联。此外，在进行错误发现率（FDR）校正后，HC、WHR（校正BMI后）和BMI与NAFLD风险的其他因果关系未保留。
本研究建立了一种因果关系，表明WC增加与NAFLD风险更高相关。这表明适当降低WC有利于预防NAFLD。
